Assignment Task:
The nurse is caring for a 5-year-old male who has come to the ER with abdominal pain. Use the chart to answer the questions. The chart may update as the scenario progresses.
History & Physical
Client is a 5-year-old male who presents to the ER with a chief complaint of abdominal pain. He is accompanied by his mother
History of Present Illness: Client's mother reports that he has been complaining of abdominal pain for 3 days. Mother states that the client's pain first started at night, waking him from sleep, and he originally pointed to his umbilicus when asked where his pain was. The past 2 days he has been pointing to the bottom part of the right side of his abdomen. He has not wanted to eat or drink anything for 2 days. His mother thinks he might be nauseated, but he has not vomited or had any diarrhea. His last bowel movement was yesterday, and it was soft. His mother took his temperature at home this morning. It was 100.4°F (orally), and she gave him acetaminophen.
Medical History: He has no pertinent medical history
Social History: He lives in a house with his mother, father, and 2-year-old sister. They have one dog. He attends kindergarten, and his sister attends day care. No new stressors or problems at home per the mother. The family went on a vacation to the beach last week
Physical Assessment: Client is awake and alert. Lung sounds clear and equal bilaterally. S1 and S2 heart sounds, no murmur, regular rhythm. Moving all four extremities, adequate tone. Mild bruising noted on bilateral knees. Peripheral pulses 2+ in all four extremities. Capillary refill time less than 3 seconds. Normoactive bowel sounds. He reports pain in the right lower quadrant upon palpation. Client is guarding his abdomen during the examination and is lying still with his knees bent.
Medications: No daily medications. Mom gave one dose of acetaminophen this morning at about 0800.
Review the client's history and physical exam. Which findings below are consistent with a diagnosis of acute appendicitis? Select All That Apply. Need Assignment Help?
(Select All that Apply.)
- Recent travel
- 2-year-old sibling who attends day care
- Mild bruising on bilateral knees
- Rebound tenderness
- Decreased oral intake
- Temperature of 100.4 F
- Complaints of nausea
- Right lower quadrant pain